Relationship Between Estimated Pulse Wave Velocity and Mortality Risk in Patients with Atrial Fibrillation: A Retrospective Cohort Analysis of Medical Information Mart for Intensive Care-IV Database.

Abstract

Objective: Pulse wave velocity (PWV) serves as a reliable indicator of arterial stiffness and is correlated with the occurrence and prognosis of cardiovascular diseases. This analysis investigates the connection of estimated PWV (ePWV) with mortality risk among atrial fibrillation (AF) patients.

Methods: This retrospective cohort analysis incorporated data on critically ill AF patients derived from the Medical Information Mart for Intensive Care-IV (2008-2022). Estimated pulse wave velocity was computed by a validated formula. The connection of ePWV with mortality risk was examined using Cox regression analyses. Restricted cubic spline (RCS) curves were employed to evaluate the non-linear correlation and to determine the cutoff values for ePWV classification.

Results: Of these 14 659 AF patients enrolled, 30-day mortality occurred in 2587 (17.65%) patients, and 1-year mortality in 4765 (32.51%) patients. The RCS curves presented a non-linear correlation of ePWV with both 30-day and 1-year mortality risk (P < .001). Patients with ePWV levels ≥ 11.302 m/s had a higher risk of 30-day mortality (hazard ratio [HR] = 1.20 [95% CI: 1.06-1.19]) and 1-year mortality (HR = 1.11 [95% CI: 1.02-1.21]) versus those with ePWV < 11.302 m/s, and this correlation was also observed in subgroups according to age, gender, Sequential Organ Failure Assessment (SOFA) score, heart failure, vasoactive drugs, and AF types (P < .05). Moreover, ePWV levels combined with the SOFA score were a better predictor of 30-day/1-year mortality than the SOFA score alone.

Conclusion: Elevated ePWV levels were connected with a higher risk of short-term mortality among AF patients, and ePWV presented prognostic predictive ability.